And everyone shows up at once…..

Time (n) the concept that keeps everything from happening at once.

Funny, it did not seem to be in play this week. We have been on The Island now for close to two years. We have not had many visitors, in fact we have been visited by our Niece, Abbey, and last summer and otherwise, the house has been ours.

Well this week we had a few guests. Arden (a dear friend, and our current tenet on the Texas farm) had been planning a visit. He was headed back from a WHO conference on dementia in Germany and decided that if he was flying through Newark, it would not be that tough to come a little further north for a visit. This visit has been in the works for a few months. We have looked forward to this visit and had made a few plans for some of the things that we wanted to do, but mostly it would involve hanging out and being cool.

Ten days prior to his arrival, I got a call from my paternal Aunt. I had not spoken with her in some time, e-mailed infrequently, and kept up primarily through her yearly missive outlining her travel adventures from the previous year. She had come across some American Airlines super saver mileage fares and it would allow her a trip to Halifax on the cheap. Apparently she had been in touch with Dad, and soon things were squared away for a visit to Canada. Once she had settled that, she got in touch with me to see if it would be possible for a visit to the Gentle Island. Having not seen her or Dad in some time, it sounded like fun.

“When do you all plan on arriving?”
“We will land on Tuesday and try to come see you on Wednesday.”
“Next week?”
“Yeah next week.”

So suddenly we had Arden here, and then after a few days, Charlie, Nita, and Ronnie would be spending a few days in our neck of the woods. The schedule was changed, but what the heck. So, after a little bit of work, we had recommended some lodging in the area and things settled down.

Thankfully the weather held for most of the week so that everyone got to see the island at a pretty moment in time. It was not as warm as we would have liked, but you can’t get everything. We have more visitors for the summer yet to come. We are expecting another visit from Abbey in June and a visit from Katy and Johnny in July. All in all it will be a busy summer.

Well the Strawberry plants need some attention and I still have to give the garden a quick weeding. Hope your days are as fun filled and that time will keep you from having to do it all at once.

Reflections on practice

It has been a while since I attended an international conference. In fact, I have not really been to any formal national or international conferences since I moved from Texas to PEI. I am spending today and the next several days in Vancouver, British Columbia at the Society of Teachers of Family Medicine, STFM. Today the preconference workshop on Palliative Care promoted a reflective sense, and allowed the opportunity to look back at how much has changed during the last two years.

The pre-conference workshop was geared toward developing a curriculum for the education of residents and students in palliative care. It may have been the group, the topic, or the electromagnetic forces at play, but the room was full of many people who love what they do, strive to be the best at their profession, and are keenly aware of their short comings in their endeavor. It was interesting to sit in a room full of people who are mindful. The listening and discussion had a different tone in this room, it reflected the struggle. Into this room, at the close of the day, we turned our attention to ‘self care’.

In the realm of palliative care it is a fact that burnout shadows the work, and in the crucible of academic medicine, the shadows may overtake you before you are aware. In an effort to assess our needs as a group, a small exercise was in order, a pictogram representing where our time and efforts are spent. After drawing a box and labeling the corners (work, family, friends, self-care) the time was divided to reflect the amount of time and energy we spent in each corner. The comparison of my time slices today look very different from the slices two years ago.
Then
Work 70 hours (71%) Family 14 hours (14%)
Friends 7 hours (7%) Self care 7 hours (7%)

Now
Work 50 hours (58%) Family 21 hours (36%)
Friends 7 hours (8%) Self care 7 hours (8%)

The feeling surrounding life has changed far more than the 13% reduction in my work hours reflect. The chaos that comprised a fair bit of life is no longer present. The sense of having to run to keep up is virtually absent, and the smoldering resentment surrounding work has vanished. This change has allowed for a more important evolution in patient care, it has allowed for the return of empathy.

Mindful patient care is something that is difficult to achieve if you have sliced your time so thin as to become transparent. If there is no substance to you, no opportunity to focus your attention on the patient at hand, then you are unable to be mindful and present in the room with the patient. It is this presence that is transformative. Being present, attentive, and without distraction allows you to see the patient as they are, at that moment, in the moment. In seeing the patient, the moment for change occurs. The ability to look past the superficial mask which we all wear allows you the chance to speak to that divine spark within each of us, that little bit of God we all hold, the portion of each patient that can effect change. It is seeing this person, hearing this person, and speaking to this person that we act in ways that allow them to see the change, to become the change.

It is in the quiet times that we can look and see the things that need to be done, and move the things that need moving. On the Island, in my practice, with my patients, I am privileged to observe the comings and goings of these quiet times in the patients and families for whom I care.

Namaste

Signs of Spring.....

The calendar tells me that today is the first day of spring, the vernal equinox, the day the sun crosses the equator. In watching the sunrise at 7:20 am and set at 7:27 pm I confirm the calendar, but the arrival of spring seems so much more than the length of the day or the date on the calendar. Spring does not greet you with a harsh slap on the face like winter, and it does not induce nostalgia in tones of sepia as autumn. Spring is quiet, gentle, easing your senses out of their slumber after a winter’s nap. It is a comfortable season, you are surprised when you look around and find that it has arrived while you were attending to other business.

On the island, spring gives you subtle clues that it is coming. We did not appreciate those clues last year as we were being pummeled by a snow that continued to fall well into April. The island weather has been gentle this year and we have kept our senses open for the changes that indicate the subtle arrival of the gentle season. The undeniable urge to start going through the garage and discard anything that you have not used in over a year is surely one of the first signs we encountered. The fact that we built a barn this year and had a significant amount of construction debris likely played a small part in the early arrival of this impulse. It was on one of our ‘dump runs’ that we noticed several other signs of the season.

As we finished loading the back of the Suburban with the construction debris, we paused for a moment to listen to a sound that had not been heard since November. The sound of several hundred nesting seagulls that inhabit a small sand bar in the middle of the bay our house overlooks. Their raucous caws and cries were a welcome sound, complimented later in the day by several over flights of geese returning to the island from the winter feeding grounds.

Along the roadway we noticed Islanders going about their business, clearing away the road sand that had gathered in their drives over the winter. Like the seagulls, the Islanders began to pop out of the homes, cleaning their cars, washing the front porch, and hanging laundry on the line to capture some of the sun’s warmth that had begun to arrive. In the flower beds, the first of the paper-whites have begun to erupt from the snow cleared ground, and in the pasture, the horses are all enjoying long rolls in the soft earth as they work to shed out the winter coat.

In a short time, the days will warm and lengthen; summer will surely arrive with the obligations of the garden, the yard, and the flower beds. But for now, with an afternoon of sun, the chores completed, we take a moment to sit, breath in the changing of the season, and rejoice in the arrival of spring.